Despite promises that the Senate would propose legislation that would support the health of all Americans, the bill released today would endanger the lives of the most vulnerable members of our community.

In particular, this proposal contains four provisions that would be extremely harmful to health:

First, the bill eliminates the Medicaid expansion and places a cap on the amount states can pay on Medicaid per person, which means that millions of children, mothers, older adults, people with disabilities, and hard-working families with low incomes could lose their health coverage. In Maryland, 1.3 million children, adults, and seniors rely on Medicaid for critical health services such as treatment for asthma and infectious diseases, prenatal care, glasses, hearing aids, prescription medications, and more. This will take us back to a time when people had to choose between basic needs, such as paying for food or rent, and their medical care.

Second, the bill allows states to apply for waivers to remove the requirement that health plans cover essential health benefits. That means:

Insurers are no longer required to cover basic maternity care, forcing pregnant women to pay tens of thousands of dollars out of pocket or forgo prenatal care. Studies have shown that women who do not receive prenatal care are five times more likely to have infants who die than women who do have prenatal services.

Insurers can exclude coverage for emergency services and hospitalization. Victims of car accidents may become bankrupt from hundreds of thousands of dollars of medical debt.

Insurers can stop providing coverage for mental health and addiction services. At a time of a public health emergency around opioid overdose, this will cost millions more lives.

Third, the bill increases the cost of insurance premiums for seniors. The Senate bill allows insurers to charge older adults five times more for health insurance than younger people, which puts the health of millions of seniors in jeopardy. Now, insurers can charge even higher amounts and push tens of millions of seniors off of their health insurance. These older adults will not be able to afford prescription medication, glasses, hearing aids, and nursing home care.

Fourth, the bill reduces access to health coverage for many of our most vulnerable residents. The Senate bill slows the growth of Medicaid spending even more than the House version, while also allowing states to create a work requirement for those receiving Medicaid benefits. This failure to recognize health care as a universal right threatens the well-being of millions of residents.

The Senate’s proposal will hurt – not help – the health of Americans. I urge our nation’s leaders to consider and act in the best interest of the well-being of our fellow community members. Millions of Americans depend on us to safeguard life.

Dr. Leana Wen is the commissioner of health in Baltimore City. Twitter: @DrLeanaWen and @BMore_Healthy.